SYMPTOMATIC OSTEONECROSIS IN RECIPIENTS O F NONAUTOLOGOUS BONE-MARROWTRANSPLANTS

A retrospective study of 36 allogeneic bone marrow transplant recipien ts was conducted to determine the rate of occurrence of and risk facto rs for avascular osteonecrosis. Eight patients developed osteonecrosis , after a mean time interval of 18 months. Multiple sites were often i nvolved (mean 2.37 per patient). Advanced roentgenologic lesions were present at diagnosis in most instances. The occurrence of osteonecrosi s was not significantly correlated with the initial hematologic diagno sis, the preparative regimen, serum lipid abnormalities, presence of a cute or chronic graft-versus-host disease, or corticosteroid therapy c haracteristics. Intraosseous blood vessels exhibited histologic lesion s consistent with a role of graft-versus-host-disease vasculitis in th e occurrence of osteonecrosis in nonautologous bone marrow transplant recipients.